Resuscitation
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Comparative Study
Emergency echocardiography to detect pericardial effusion in patients in PEA and near-PEA states.
Emergency echocardiography (EM echo) has been proposed to assist in decision-making in patients with pulseless electric activity (PEA) or PEA-like states. We observed the value of EM echo by emergency physicians in detecting pericardial effusion in patients in PEA and near PEA states. ⋯ Emergency echocardiography performed by emergency physicians in patients in PEA or near PEA states can detect pericardial effusions with correctable etiologies versus true PEA with ventricular standstill.
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The charts of all adult patients with accidental hypothermia who were admitted to a single academic hospital during a 10 year period were retrospectively retrieved. The aim was to identify factors associated with survival of those with hypothermic cardiac arrest. Of 75 admitted patients, 44 were found to be haemodynamically stable and not to require invasive rewarming measures. ⋯ Logistic regression analysis showed that of the 23 patients, 22 could be correctly classified as survivor or nonsurvivor based on the level of serum potassium and arterial pCO2. It is concluded that patients with cardiac arrest due to primary hypothermia tolerate long periods of conventional CPR before institution of CPB. The possible predictive role of serum potassium and arterial pCO2 needs further evaluation.
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To clarify the incidence and survival rate of bystander-witnessed out-of-hospital cardiac arrests (OHCA) with cardiac etiology in Osaka Prefecture, Japan, with a population of nearly 9 million according to the Utstein style. ⋯ The incidence of bystander-witnessed (OHCA) with cardiac etiology and VF or VT were remarkably low compared with those reported by other studies conducted in some areas of Europe or the USA.
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During reperfusion of ischemic myocardium nitric oxide (NO) reacts with superoxide radicals to form cardiotoxic peroxynitrite, which causes lipid peroxidation. Our hypothesis was that infusion of a NO donor S-nitroso-N-acetylpenicillamine (SNAP) during ischemia-reperfusion would exacerbate the oxidative damage to the myocardium by increased formation of nitrogen radicals. ⋯ The NO donor SNAP increased free radical concentration and exacerbated myocardial oxidative damage after ischemia-reperfusion.
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Comparative Study
Comparison of standard CPR versus diffuse and stacked hand position interposed abdominal compression-CPR in a swine model.
Interposed abdominal compression cardiopulmonary resuscitation (IAC-CPR) is an innovative basic life support technique requiring no mechanical adjuncts. Optimizing its performance remains a challenge. Hand-position technique over the abdomen during interposed abdominal compression (IAC) may be important. ⋯ No CPR-produced trauma difference was found. Abdominal hand position (diffuse or stacked) did not affect blood flow in either the aorta or IVC or resuscitation success in this experimental model. There was a trend towards better outcomes with stacked hands IAC-CPR with 90 versus 70% survival with STD-CPR.